Mental Health & Medicine
You may have stumbled across my website after learning about my arguments in mental health and medicine. Although most of my research is in academic political science, I have found that my book project and related work carry practical implications for these fields.
Perhaps the most important of which is that community and hospital psychiatry may have a complementary relationship -- contrary to the presumptions driving de-institutionalization. Mental health care, in addition, appears to require more public funds than other areas of health care.
Please see below for more information.
2021. Julia F. Lynch, Isabel M. Perera, and Theodore J. Iwashyna. "Scarce Resource Allocation in a Pandemic: A Protocol to Promote Equity, Timeliness, and Transparency" in Critical Care Explorations
Blog post: Life in the Fast Lane (4/2020)
2020. Isabel M. Perera, “The Relationship between Hospital and Community Psychiatry: Complements, Not Substitutes?” in Psychiatric Services
Top PS Altmetric score in the first month of publication
Featured in: Treatment Advocacy Center Research Weekly, 1/2020; Keynote address of Dr. David Copolov at the Royal Australian and New Zealand College of Psychiatry Congress, intended for 5/2020, but cancelled due to Covid-19
Community-based psychiatric services are essential to mental health. For decades, researchers, advocates, and policy makers have presumed that expanding the supply of these services hinges on reducing the supply of hospital-based care. Cross-national data from the World Health Organization call this presumption into question. Community and hospital psychiatry appear to be complements, not substitutes.
2020. Stephen Allison, Tarun Bastiampillai, Jeffrey C.L. Looi, Simon Judkins, and Isabel M. Perera. "Emergency department–focused mental health policies for people with severe mental illness," in the Australian and New Zealand Journal of Psychiatry
The Australasian College for Emergency Medicine (ACEM) has released a major report on Australia’s mental health system: Nowhere to go: Why Australia’s health system results in people with mental illness getting ‘stuck’ in emergency departments. The report is significant for several reasons. First, ACEM joins the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in national advocacy for improved mental healthcare (Jenkins, 2019; Judkins et al., 2019). Second, the report presents a clear case for an emergency department (ED) focus in national mental health policymaking, along with well-defined outcome measures including ED length of stay (LOS). Finally, the report takes a balanced approach to community and hospital services: ‘ACEM will also continue to advocate for governments to increase the amount of inpatient mental health services and community mental health services to ensure that people with mental health needs have sufficient and equable access to appropriate services’ (ACEM Report, p. iii).
2019. Isabel M. Perera and Dominic A. Sisti, “Mass Shootings and Psychiatric Deinstitutionalization, Here and Abroad,” in the American Journal of Public Health [PDF]
Is deinstitutionalization to blame for the regularity of mass shootings in America? Deinstitutionalization occurred not only here but also across other high-income democracies. Major international organizations, such as the World Health Organization, have supported the reduction of hospital psychiatry. Comparing cross-national data of mass shootings—typically defined as four or more fatalities—with the decline of inpatient psychiatric capacity offers little evidence to support this association.
Compared with the general health system, the mental health system faces distinct challenges. Perennial flashpoints include issues of stigma, coercive treatment, and nosology, which generate heated ethical and policy debates. Often overlooked, however, is another characteristic of the mental health sector: its financial dependence on the public purse
2019. Aaron J. Glickman, Isabel M. Perera, and Dominic A. Sisti “The Institutions for Mental Diseases Exclusion Rule is an Anachronism,” in The Regulatory Review
The time has come for repealing Medicaid’s Institutions for Mental Diseases Exclusion rule.
2019. Isabel M. Perera, “Mental health and politics since the eurozone crisis,” in European Psychiatry [PDF]
Some of the most immediate health effects of the 2008 economic crisis concerned the mind, not the body. Rates of generalized anxiety, chronic depression, and even suicide spiked in many European societies. This viewpoint highlights the role of mental health professionals in responding to this emergency, and argues that their sustained mobilization is necessary to its long-term resolution.
2013. “Health Effects of the Crisis in Southern Europe,” with Julia F. Lynch in the APSA European Politics and Society Newsletter (Summer, 11-14).